Care Home: Cordwainers

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What the care home does well There is detailed information about peoples` needs and about how people prefer to be supported. This means that staff know how people want to be supported and so give the right support. The house is well maintained with framed photographs of service users around the home enjoying events and activities including holidays. This makes it feel homely. Staff give service users the time they need to do things and encourage service users to do as much for themselves as possible. We observed staff encouraging and supporting people to do things for themselves. This means that people have the opportunity to develop and increase their skills. Staff have access to a programme of ongoing training. This means that staff have the skills they need to support service users. Communication is supported by way of individual guidelines and communication boards. This means that service users know who is on duty and what activities are on offer and so have some control. Risk assessments are detailed and show what action staff should take to reduce and minimise risks. This protects service users. What has improved since the last inspection? The manager had been seconded to support anther service but is now back full time at Cordwainers. Service users said they are happy about this. There has been some decorating and a new television and furniture has been purchased. Health action plans have been improved and the manager plans to implement these. Work has stared on individual person centred plans. The manager plans to continue this so everyone has a plan that shows their personal goals and aspirations and how staff should support this. The frequency of supervision for the manager has improved. This means that the manager has the support, mentoring and coaching she needs. What the care home could do better: Some personal goals and aspirations are recorded but there are currently no detailed plans of support. This means that people may not have the support they need to achieve their goals and aspirations. The manager said that the new format support plans would include a plan of support. CARE HOME ADULTS 18-65 Cordwainers Chase Road Lindford Hampshire GU35 0RW Lead Inspector Kim Rogers Unannounced Inspection 30th December 2008 09:00 Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cordwainers Address Chase Road Lindford Hampshire GU35 0RW 01420 472459 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Robinia Care Ltd Miss Nikki Anne Bedford Care Home 8 Category(ies) of Learning disability (0) registration, with number of places Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 8. Date of last inspection 23rd August 2006 Brief Description of the Service: Cordwainers is a home for eight young people with learning disabilities, three of whom may be sixteen or seventeen years of age. The home is a large extended bungalow, situated in a quiet residential area in the village of Lindford, Hampshire. The bungalow has been modified to provide accommodation for wheel chair users. All residents are accommodated in single rooms. There is a large enclosed garden and patio area to the rear of the property. The home is owned and operated by Robinia Care Ltd, an organisation that has provided care services, mainly in the learning disabilities sector, since 1995. The fee for the home ranges from about £1000 to £1900 per week. For more information about the home and fees please contact the Provider. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out by one inspector and was unannounced. The key Minimum Standards were assessed. The inspection included a site visit to the service of about four hours. The inspector spoke to service users, staff and the manager, had a look around the home, made observations and sampled records. The manager completed the Annual Quality Assurance Assessment (AQAA). This is completed each year and shows what the home does well and how they intend to improve the service. The AQAA also gives information about staff and facilities. We looked at notifications form the home about incidents and accidents and we listened to what people told us about the service. People who use the service said they feel safe and are happy at Cordwainers. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: There is detailed information about peoples needs and about how people prefer to be supported. This means that staff know how people want to be supported and so give the right support. The house is well maintained with framed photographs of service users around the home enjoying events and activities including holidays. This makes it feel homely. Staff give service users the time they need to do things and encourage service users to do as much for themselves as possible. We observed staff encouraging and supporting people to do things for themselves. This means that people have the opportunity to develop and increase their skills. Staff have access to a programme of ongoing training. This means that staff have the skills they need to support service users. Communication is supported by way of individual guidelines and communication boards. This means that service users know who is on duty and what activities are on offer and so have some control. Risk assessments are detailed and show what action staff should take to reduce and minimise risks. This protects service users. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People have the information they need to make a decision about moving in. Assessments of a persons needs are carried out before a person moves in so staff know they can meet the persons needs. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that there is good information about the home including colour photographs and large print. This means that people have meaningful information about the service to help them make a decision about moving in. The manager said that assessments are carried out before a person moves in. This is done to ensure the home can meet the persons needs. An assessment was seen and we found that although needs are detailed there is no mention of the persons personal goals and aspirations, as the Minimum Standard requires. The manager agreed to address this so that people know the home can support their goals as well as their needs. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People know their needs will be supported. Risks are assessed and well managed and communication is supported so people can make choices and decisions. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has an individual support plan and a start has been made on individual person centred plans. Individual needs are well detailed ensuring that staff have the information they need to give people the right support. We found that for some people personal goals and aspirations are not recorded. There are no plans in place to support personal goals and aspirations. For example one person wants a particular type of holiday but we found no plan in place to say how this was going to happen. This means that people may not have the support they need to achieve their goals and Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 10 ambitions. The manager said the new person centred planning format includes action plans to ensure staff support peoples goals. The manager has reviewed how people are supported at night. Service users have been consulted about this and guidelines reviewed to ensure that service users are supported at night in the way they prefer. We found that potential risks to people are identified and recorded with action by staff recorded to reduce and minimise risks. We found that risk assessments do not limit people. This keeps people safe and well and protects service users. Minimum restrictions are imposed. Where there are restrictions they are regularly reviewed and made in peoples best interests. We found that communication is supported. This means that people have the support they need to make choices and decisions. For example people have communication books, which detail how they prefer to communicate. There is a board showing photographs of staff on duty so people can see for themselves who is to support them rather than having to ask. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People have the opportunity to take part in a range of activities and hobbies are supported. People have the support they need to keep in touch with family and friends. Food is nutritious and people take part in planning and preparing meals. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that people have the opportunity to take part in a range of activities. People said they enjoy going to day centres and clubs and are planning a New Year party. We found that hobbies are supported. For example one person had support to see their favourite pop group in concert. Facilities in the local community are accessed like shops and pubs with the use of an adapted vehicle. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 12 Each person has an activity planner. These cover Monday to Friday and have one entry per day so do not include evenings or weekends. The manager said she plans to improve this so people have the opportunity of taking part in more planned activities. People have the support they need to keep in touch with family and friends. We found that contact details of family and friends are recorded and visitors are welcome at reasonable times. Families are involved in peoples support if they want them to be. We found that the kitchen is accessible and people are involved in planning and preparing meals and snacks. People said they have a choice about what they eat and where they eat. We observed people being asked what they would like to eat. We observed staff giving discreet support with food and drinks. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People know that their personal care and health needs will be supported. Medication practice is safe protecting service users. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that peoples personal care needs are well detailed in individual plans. This means that people are supported in the way they prefer. People said staff help them with baths and that staff are respectful in their support. Health needs are recorded and records kept of health appointments. Staff work closely with health professionals and make referrals for support when needed. Each person has a health action plan which they have been involved in developing giving people control and responsibility. The manager plans to introduce an improved health action plan format. We found good records of monitoring of health needs. This means that staff can pick up any changes in health needs at an early stage. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 14 We sampled medication records and storage. We found that storage is safe and records are in order. Staff currently control medication. The manager said there are plans for some people to take some control of their medication with staff support. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service know that their complaints will be listened to and acted on. People are safeguarded from harm and abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy and procedure. This is produced in text, photographs and symbols, which makes it more meaningful to people. Service users said they would talk to staff or the manager if they had a concern or complaint and that it would be sorted out. Neither the home nor the Commission have received any complaints about the service since the last inspection. There have been no safeguarding alerts. There is a safeguarding policy and procedure and whistle blowing policy. The manager has collated information about safeguarding vulnerable adults as a reference tool for staff. Staff have training in how to recognise and respond to possible abuse. This protects service users. Service users said they feel safe at Cordwainers. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People lives are enhanced by a clean, safe, well-maintained home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that the home is well maintained and suitable for service users needs. There is good access to the garden from both lounges. People said they enjoy spending time in the garden and grew vegetables in the raised beds. There are photographs of service users enjoying outings, events and holidays framed around the house. This makes it feel homely. Each room is single with a wash hand basin. Bathrooms and toilets are suitable for peoples needs and are sited close to bedrooms. People said they are happy with their rooms. We found the home is clean and hygienic. Staff support service users to do the housework and laundry so that everyone is involved. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 17 There has been some redecoration and new furniture purchased recently. A new television has been purchased for one of the lounges. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service are supported by enough trained, competent staff. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found that there are enough staff on duty to meet service users needs. The home is using some agency staff at present. The manager said that one full time vacancy for a night staff has been filled and they plan to recruit to a part time day staff post. This means that agency staff will not be needed and will give service users more continuity of care and support. Staff currently work long shifts of either twelve or fifteen hours. This means they could be tired and stressed. The manager said she would be talking to staff and service users about this and reviewing the length of shifts. There is a training manager and staff have access to a range of courses. This includes mandatory subjects as well as courses related to service users needs. Induction for new staff is in line with the Minimum Standard. This means that staff have the training they need to support service users. Regular staff meetings are held which helps communication between staff. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 19 We found that checks are carried out before a person works at the home. This ensures that service users are protected. Service users said the have been involved in interviewing staff. The manager said there are plans for training for service users in recruiting staff. This means that service users can have a say about who may potentially support them. We observed staff supporting people with patience and kindness. A service user said that their key worker is excellent and does her job really well. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The home is well managed and is run in service users best interests. The health and safety of service uses and staff is protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management of the home is stable. The manager is now back working full time at the home after being seconded to support another service. Service users said they are pleased that the manager is back at Cordwainers. The manager has the required qualifications and has several years experience. The manager spoke with knowledge and understanding of service users needs and has plans to improve the service and outcomes for people. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 21 We found that views of the people who use the service are listened to and acted on. Regular service user meetings are held and yearly surveys are sent out to service users and stakeholders. This means that service users can effect change and underpin improvement. An area manager carries out monthly monitoring visits and supervises and supports the manager. We found that the manager also conducts regular audits and checks of records to ensure service users are protected. The AQAA shows that checks are carried out of facilities and equipment protecting service users and staff. We found that fire drills are held and fire equipment is checked to ensure it is safe and working. Service users said they are included in fire drills and know what to do in the event of a fire. Staff have training in areas of health and safety like fire awareness, food safety and safe moving and handling. We observed service users being moved and handled safely and with respect for their dignity. Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cordwainers DS0000011561.V373251.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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